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Fair comparisons of hospitals' performance require reliable methods to account for differences in patients' baseline characteristics and predicted risk for adverse events, because otherwise hospitals would be penalized for treating sicker patients. The Centers for Medicare and Medicaid Services (CMS) has proposed a risk-adjustment model for comparing hospitals' mortality rates after stroke. However, this model relies on administrative data and does not account for stroke severity, prompting concern that it would imperfectly capture baseline differences. To address this concern, investigators have compared the performance of the proposed CMS model with and without an added measure of baseline stroke severity.
By linking CMS claims data to the…